Laserfiche WebLink
LAND USE PERMIT APPLICATION — Burnett County, WI a ro <br /> Applicant Complete All Sections Below This Line 0. w <br /> Permit Types and Fees:(Please,check appropriate boxes) n <br /> C7 <br /> Dwelling/Principal Structure $300 X Addition/Alteration to Dwelling/Principal Structure $200 o <br /> Commercial/Industrial Structure $300 Addition/Alteration to Commercial/Industrial Structure $200 0 O <br /> Accessory Structure(Garage,Shed,etc.) $150 Addition/Alteration to Accessory Structure $150 o <br /> Accessory Structure(Commercial/Industrial) $200 Addition/Alteration to Bunkhouse $150 <br /> la <br /> Deck/Stairs/Patio/Retaining Wall/Sidewalk Bunkhouse $250 °. <br /> Driveways/&Campground Structures $125 WI State Statute 59.692(1v)Structures $350 c <br /> Filling/Grading $150 Boathouse $500 <br /> Solar Panels(Stand alone or roof mounted) $150 Permit Extension(1 Year Extension-Allowed Once) $100 I : <br /> `NOTE:After-the-fact permits(permit acquired after construction has begun)may cost up to three times the normal fee. <br /> -v <br /> *Communication Towers,Camping Permits&Signs require a different application form;see corresponding application,and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas,landscaping,etc. Pa • <br /> z <br /> Property Owner's Name: M 0,1'i (•I H/ a 1 d.. K u$i-e►-) D e.c-1«v- o *-., <br /> Property Owner's Mailing Address: 11 Li G Li Go-0 QR.. A V e.- uc totl 1I i e h"I t J s s'544f II. t <br /> Pro e Site Address: i 3 3 ( , R c b exts a <br /> City State Zip f— 4 <br /> P rt3 I\C� S •�c�Gl�e� ► lAJ1.r- 5 I-I 90 1 Q o <br /> H g , <br /> Contact's Telephone Number: Co 1 2 - Co I (o - 30LI 7 o. <br /> J d eck esr 1 n <br /> Contact's Email: � � �i L�'��►� ter, �1 e� V <br /> **If staff has a question about this application,you will be contacted via email. Make sure your email address is N M <br /> legible and your email provider will accept emails from the following addresses: @BurnettCounty.org and c b4 <br /> @BurnettCountyWl.gov 144, q c5eti v )a P 60 (64 Gou. t.o+-a)43$6043 o d <br /> Legal Description of Property: SEE- oeXtra -H ED C>a. <br /> Section#: oZ y Town#: (V N Range#: 14 W Town of: 7Col-4- ` co <br /> additional page if needed for lengthy description OR attach a copy of the deed OR attach tax system property page.* :� c71 x <br /> Tax ID#(1-5 digit number;found on tax statement): I S 5'3 0 <br /> Proposed Use of Structure/Addition: B e,„1 %r c O till GQ <br /> Anticipated Start Date: /V1 d,y Z. L t- (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) <br /> Building Contractor: -j'BD Sewer Installer: 1'1 f' <br /> z <br /> AREA BELOW THIS LINE FOR LAND SERVICES STAFF COMMENTS/CONDITIONS ONLY x) <br /> THIS PERMIT IS SUBJECT TO ALL CONDITIONS LISTED BELOW: <br /> grnee+ a)I 5e+bcck7o3 <br /> D wci��1�I n }„d-i-- excel 3 rcq/ns 5�N_ <br /> S 'fJ be ►'trno J �� '„`� U £ l/1) y-r� r� on 5 e N Fee Rec:b8:14ep <br /> ' li ✓e of 5�CYfgd/I IS � d Q o Check#: 9 g5�3 <br /> 1:d b 644/? 1 Irr, <br /> Date of staff site visit: 11a?3 Init/ial�of s' a v' it staff: �f/ <rri z <br /> / �7 nil <br /> n t> <br /> APPROVED BY LAND SERVICES OFFICIAL L��J •/ DATE: M 6! ! /01 3 cn 0 W m C0 <br /> 11 a < = <br /> > 6 m <br /> UPON APPROVAL: APPLICANT MUST POST COPY OF o 0 0 <br /> SIGNED PERMIT APPLICATION IN PLAIN SIGHT . 3 w <br /> ffil <br /> Page 1 of 5 < m I ' <br /> Burnett County, WI Land Use Application—Rev 5/2023 0 �� <br /> a <br />